title: Local drug delivery for oral mucosal diseases: challenges and opportunities.
abstract: There are few topical formulations used for oral medicine applications most of which have been developed for the management of dermatological conditions. As such, numerous obstacles are faced when utilizing these preparations in the oral cavity, namely enzymatic degradation, taste, limited surface area, poor tissue penetration and accidental swallowing. In this review, we discuss common mucosal diseases such as oral cancer, mucositis, vesiculo-erosive conditions, infections, neuropathic pain and salivary dysfunction, which could benefit from topical delivery systems designed specifically for the oral mucosa, which are capable of sustained release. Each condition requires distinct penetration and drug retention profiles in order to optimize treatment and minimize side effects. Local drug delivery may provide a more targeted and efficient drug-delivery option than systemic delivery for diseases of the oral mucosa. We identify those mucosal diseases currently being treated, the challenges that must be overcome and the potential of novel therapies. Novel biological therapies such as macromolecular biological drugs, peptides and gene therapy may be of value in the treatment of many chronic oral conditions and thus in oral medicine if their delivery can be optimized.
authors.affiliation: Department of Comprehensive Dentistry, The University of Texas Health Science Center at San Antonio, TX, USA.
authors.forename: V
authors.initials: V
authors.lastname: Sankar
authors.forename: V
authors.initials: V
authors.lastname: Hearnden
authors.forename: K
authors.initials: K
authors.lastname: Hull
authors.forename: D Vidovic
authors.initials: DV
authors.lastname: Juras
authors.forename: M S
authors.initials: MS
authors.lastname: Greenberg
authors.forename: A R
authors.initials: AR
authors.lastname: Kerr
authors.forename: P B
authors.initials: PB
authors.lastname: Lockhart
authors.forename: L L
authors.initials: LL
authors.lastname: Patton
authors.forename: S
authors.initials: S
authors.lastname: Porter
authors.forename: M
authors.initials: M
authors.lastname: Thornhill
mesh_terms: D001685:Biological Factors / Q000627:therapeutic use; D003692:Delayed-Action Preparations; D016503:Drug Delivery Systems; D015316:Genetic Therapy; D006801:Humans; D046911:Macromolecular Substances / Q000627:therapeutic use; D058990:Molecular Targeted Therapy; D009059:Mouth Diseases / Q000188:drug therapy*; D009061:Mouth Mucosa / Q000187:drug effects; D009062:Mouth Neoplasms / Q000188:drug therapy; D012466:Salivary Gland Diseases / Q000188:drug therapy
chemical_list: D001685:Biological Factors; D003692:Delayed-Action Preparations; D046911:Macromolecular Substances